Barrier creams or sprays can be used for a short period of time. Non-sting stoma pastes to help with adhesion of to the flange to the skin. Topical steroid lotions can be used as a short course of treatment if irritation is severe, these would need to be prescribed by your stoma nurse or GP.
You may wish to apply a skin barrier cream to the sore skin before applying your stoma pouch. This will help soothe any irritated skin. iLex is an extremely popular cream that many ostomates swear by.
Skin irritation around your stoma is usually caused by leakage from your ostomy pouch and the output from your stoma getting underneath the adhesive and onto your skin. It is uncomfortable and can stop your pouch from working well.
Cover the irritated skin with a thin hydrocolloid sheet (dressing) or liquid skin protectant (such as MARATHON® Liquid Skin Protectant). Apply your pouching system over the thin hydrocolloid sheet or liquid skin protectant. Avoid using ostomy powder or skin prep wipes for more than a couple of days at a time.
A urostomy will pass urine and a small amount of mucus into a drainable bag that is fastened with a bung or a tap (Burch, 2008). These bags can be used alone, but many people with a stoma (ostomates), in addition to their appliance, also need a stoma accessory, such as a barrier cream.
An effective barrier to protect intact skin from the harmful effects of bodily fluids, such as stoma output and excessive perspiration.
If your skin is exposed to the output of the stoma this can result in sore skin developing. Check to see if the adhesive has eroded, if so your stoma bag may have needed changing sooner. If this is the case, it may be beneficial to change your stoma bag more regularly.
Skin Irritation
This is usually due to leakage from the ostomy device. This is when output from the stoma seeps under the adhesive part of the wafer and output is now touching the skin. This can be painful as well as damaging to your skin and your ostomy device.
Most commonly with an ileostomy, redness to the skin around the stoma, accompanied by burning and itching, is the result of stool having direct contact with the skin. Stool from an ileostomy is corrosive and can cause damage to the skin within a short period of time.
To clean the skin around your stoma, all you really need to use is warm water and a washcloth (or good quality paper towels). The use of gauze or gloves is not usually necessary, although you can use them if you feel more comfortable.
Most people with stomas may have to go through a stoma infection. However, it is a possibility that anyone with a stoma should know about it. The first sign of a stoma infection may be a pus-like discharge, unusual swelling, increasing redness, or color changes.
In most cases, granulomas are small, raised, red bumps around the stoma. Often occurring at the junction where the stoma joins the skin, but can also be seen on the stoma itself. For some, the granuloma is not obvious at all, but can cause some bleeding which may lead you to seek a review of your stoma.
When the skin becomes infected it can start to look inflamed and the infection tends to cause some swelling around your stoma. The skin colour often changes from a healthy pink/reddish colour, to pale, bluish purple or even black. If there is any discharge of blood or pus this is often a definitive sign of infection.
Small ulcerations can usually be treated with stoma powder or antimicrobial powder covered by a piece of hydrocolloid. A foam dressing over the ulceration is helpful if the ulcer is particularly moist. Silver dressings in sheet form or calcium alginates have also been effective.
Showering and bathing is part of everyone's daily routine and should be still enjoyed even if you have a stoma. You may feel concerned about getting your stoma or skin wet, but normal exposure to water and air will not harm your stoma in any way.
A stoma hernia resembles a bulge or a lump. Many people describe it a looking like a “golf ball” or a “grapefruit” behind their stoma. Having a hernia can cause your stoma to look more pronounced and potentially change shape, it may also appear larger or flatter than it did before the hernia.
A parastomal hernia is where the intestines push through the muscles around the stoma, resulting in a noticeable bulge under the skin. To reduce your risk of getting a hernia: wear a support garment (belt or underwear) avoid heavy lifting and straining.
The easiest way to clean your stoma site is to gently wash it with warm water using the dry wipes provided and then pat dry thoroughly using a clean dry wipe. Avoid using paper towels as these can get stuck to the stoma, always use dry cotton wipes.
The area near the minor skin breakdown becomes bright red, swollen or painful. There is odor coming from the open skin. The drainage from the open skin becomes yellow or green in color.
Although uncommon, some people may suffer from allergic contact dermatitis to components such as preservatives, fragrances, and other ingredients in barrier creams. Some occlusive barrier creams may also aggravate acne when applied to the face. Most barrier creams should not be applied directly to broken skin.
Or, if you prefer, you can apply the paste directly to clean, dry skin around your stoma. Allow it to sit for a few minutes, while you prepare to apply the pouching system. Center the skin barrier opening on the stoma and gently press it against the skin for a minute.
If the opening on your pouching system is too large or does not adhere well, the drainage from the stoma can damage the skin. Irritated skin that develops under the skin barrier can occur for a variety of reasons. Your skin may have become damaged from incorrect or frequent removal.